MP30-04 CLINICAL OUTCOMES OF CRYPTOZOOSPERMIC PATIENTS UNDERGOING SURGICAL SPERM RETRIEVAL

Abstract

You have accessJournal of UrologyCME1 Apr 2023MP30-04 CLINICAL OUTCOMES OF CRYPTOZOOSPERMIC PATIENTS UNDERGOING SURGICAL SPERM RETRIEVAL Raneen Sawaid Kaiyal, Rossella Cannarella, Shinnosuke Kuroda, Neel V. Parekh, Sarah C. Vij, and Scott Lundy Raneen Sawaid KaiyalRaneen Sawaid Kaiyal More articles by this author , Rossella CannarellaRossella Cannarella More articles by this author , Shinnosuke KurodaShinnosuke Kuroda More articles by this author , Neel V. ParekhNeel V. Parekh More articles by this author , Sarah C. VijSarah C. Vij More articles by this author , and Scott LundyScott Lundy More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003258.04AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Cryptozoospermia is defined by the World Health Organization (WHO) as the presence of isolated sperm cell in the ejaculate only identified after an extended microscopic search or after being pelleted. This sperm is usually sufficient for intracytoplasmic sperm injection (ICSI), but in some cases, ICSI fails due to sperm quality. Contention remains regarding whether testicular sperm offers any advantage in this unique situation. At our tertiary referral center, we routinely perform surgical sperm retrieval via conventional or microdissection testicular sperm extraction (TESE) for men with cryptozoospermia and failed ICSI, or where ejaculated specimens are immotile or insufficient for ICSI. In this study, we sought to describe our experience and evaluate the predictors of success in cryptozoospermic patients who had microsurgical testicular extraction (microTESE) at our center METHODS: We retrospectively reviewed our electronic medical records for all patients with cryptozoospermia who underwent microTESE performed between 2007- 2021 for failed ICSI with ejaculated sperm or who had immotile or morphologically poor sperm. We evaluated demographics, preoperative lab results, pathology results, sperm retrieval rate (SRR), and ICSI outcomes. RESULTS: 28 cryptozoospermic patients were identified and underwent 37 unique microTESE operations with demographics and outcomes listed in Table 1. 22 of these men had failed previous ICSI treatment with ejaculated sperm, while the other 6 patients had poor quality ejaculated sperm not suitable for ICSI. None had genetic abnormalities. Motile sperm suitable for ICSI was retrieved in 30 (81.0%) of these operations. 14 out of 28 patients (50%) had positive pregnancy result and 12 patients (42.8%) had successful live birth. The most common pathological pattern was hypospermatogenesis found in 65.3% (17/26). There were no postoperative complications noted. CONCLUSIONS: The use of testicular sperm in cryptozoospermic men with failed prior ICSI using ejaculated sperm has a high rate of pregnancy and live birth. While still controversial, our results suggest that surgical sperm retrieval is a viable option for these men with minimal risk of complications. Source of Funding: N/A © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e392 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Raneen Sawaid Kaiyal More articles by this author Rossella Cannarella More articles by this author Shinnosuke Kuroda More articles by this author Neel V. Parekh More articles by this author Sarah C. Vij More articles by this author Scott Lundy More articles by this author Expand All Advertisement PDF downloadLoading ...